| Heritage Valley Medical Group, Inc. | |
|
100 Foster Ave Ste B Pittsburgh PA 15205-2317 | |
| (412) 262-4694 | |
| Not Available |
| Full Name | Heritage Valley Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Foster Ave Ste B, Pittsburgh, Pennsylvania |
| Authorized Official Name and Position | Bryan J Randall (VICE PRESIDENT & CFO) |
| Authorized Official Contact | 4127497027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Valley Medical Group, Inc. 100 Foster Ave Ste B Pittsburgh PA 15205-2317 Ph: (412) 262-4694 | Heritage Valley Medical Group, Inc. 100 Foster Ave Ste B Pittsburgh PA 15205-2317 Ph: (412) 262-4694 |
| NPI Number | 1417518036 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 06/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417518036 | NPI | - | NPPES |
| 001565446 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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